Im 34 healthy male, except for chronic constipation. Since I was 14 yo. Sometimes Im fine for a few weeks, but it always comes back. My mom says I have a lazy colon as I just don't get the urge. The stool if very soft, and I drink alot of water. Alot of fiber doesn't help and makes me ill. doctor was no help. What can I do to stimulate the bowel? Laxatives, enemas don't work. I am so sick (lierally,etc) of going through this.
You said you are constipated but also mentioned that your stool is soft. If your stool is soft then you are not constipated. Consipation refers to hard dry stools that are often infrequent. Infrequent but soft stools are not constipated stools and are nothing to worry about. If you meant that your stools are soft for weeks at a time and then you have bouts of constipation, post again and I may be able to offer suggestions. If you just don't go often but the stools are not constipated then enjoy life and don't worry about things.
Hi Marc. I recognise these symptoms very well. I've had exactly the same problems over many years but have now been free of them for nearly a year.
What follows is a bit of an essay, but then it's a complicated problem.
GPs here in Britain (MDs in US? - first-line, non-specialist doctors) often prescribe fibre as a first resort for constipation. If it works, fine, but it isn't always appropriate. I was prescribed 15 different types of medication - Normacol, Normacol Special, lactulose, natural senna etc until it was coming out of my ears. They simply gave me diarrhoea for several years. I was also prescribed glycerin suppositories, phosphate enemas and many others, but none of them worked either.
Read the following, and if it doesn't work, see a gut expert - either a gastroenterologist [orthodox medicine] or colonic hydrotherapist [complementary medicine].
Don't be put off by people telling you that "constipation isn't really a problem"/"you don't have to go every day you know"/"go away and try not to worry about it" - these people have never had severe constipation! If it's anything like mine was, your constipation won't be life-threatening in itself, but the feelings of sluggishness and despondency associated with it can be hugely disruptive and demoralising.
What's probably happening with you is this:
As your waste matter is making is way through your system and gets into the colon - the large intestine - it's starting to dry out much more quickly than it should do as it turns into a formed stool. The large intestine starts above your right trouser pocket, goes upwards roughly to the level of your navel, then goes across your front to your left-hand side before dropping down again to the rectum & anus. It's whilst going along this part of the gut that waste matter which isn't able to stay moist, will instead turn hard and go dark in colour in the process.
As this dried-out stool approaches your anal canal/rectum, instead of just popping out within a few hours it'll slow right down and will often break up into lumps as it dries out. If it doesn't break up whilst still inside the colon, it'll probably do this as you're straining to defecate and only parts of it - lumps or balls - will get through.
As this happens the colon wall, which normally forces the stool along the gut towards the rectum using a movement called perestalsis, starts to lose its grip on the dry stool, which is another reason the stool won't keep moving. Perestalsis is a series of 'Mexican wave'-like contractions with which the colon forces its contents towards the rectum. (If you've ever seen a worm moving over soil, this is roughly the movement your bowel is making to try and empty itself; unfortunately this doesn't work very well with stools once they've become dry and hard and wide). These hard, dry stools are known by gastroenterologists as 'impacted stools'.
By this stage you'll be feeling very full and sluggish each day, possibly unable to concentrate.
What you need for this is a stool softener rather than a laxative, so that the stool remains moist inside the bowel - though not too soft and certainly not liquid - so that by the time it reaches the rectum it hasn't completely dried out and also so that the colon wall can grip it and eject it more easily.
Ask a gastroenterologist for advice on stool softeners, or just go straight to a colonic hydrotherapist.
Colonic hydrotherapy (also called colonic irrigation) helped me. I turned to it in desperation last year and was very sceptical but it's worked extremely well for me - 90% of the time, going to the loo is now bliss.
A hydrotherapist will probably firstly clean out the inside lining of your large intestine (this could take 3or4 sessions), and then put you on a herbal or other preparation to i) help you go and ii)improve the water-retaining ability of your colon.
The hydrotherapy also helps the colon massage itself as the process involves remove (by using a jet of water) the thick, lining of black matter that cakes up the inside of the colon. With luck you should then slowly start to go more regularly and even get a signal to 'go' - something that disappears during severe constipation.
My own stool softener is a homoeopathic (herbal) preparation recommended by my hydrotherapist here and made locally.
If there's no improvement for 2-3 weeks after your final visit to have your colon dredged out in this way, read on.
Other factors which might be causing your constipation:
* The muscle around the anus/rectum may be tightening up so that 'nothing shall pass'. This muscle is known as the 'anal sphincter'. Normally it's shut tight: if it wasn't, we'd all be incontinent. When you're opening your bowel it needs to relax properly to let all the waste matter out so that you feel properly emptied.
Unfortunately, if you have impacted stools it has to relax even more to let these (wider) stools out. If it can't, instead the hard stool stays lodged inside the rectum and more recent, softer waste matter from higher up in the colon squeezes its way past the stool and coming out through the rectum, while the hard stool stays lodged in the colon. This is known (I think) as enforced diarrhoea, but isn't really diarrhoea - it's your colon knowing that it's supposed to expel something, and expelling whatever it can.
You then have a burning sensation around the anus and a strong feeling of not having emptied yourself (because you haven't), usually accompanied by soreness.
You're also more likely to develop piles (haemorrhoids) when you're constipated, partly because when you're having to force dry, knobbly stools out through the anus, they can drag haemorrhoids out with them. A softer, smoother stool is less likely to.
It's important to be as relaxed as you possibly can be when emptying the bowel. Try reading a magazine and not worrying about whether you'll go or not, and controlling the muscle so that anything that comes out, does so in as controlled (by you) a way as possible. After all, it's got to come out sooner or later, so tell yourself you can wait as long as it can!
Biofeedback devices can help here: they sense whether the sphincter is contracting at the right time, and give you feedback to help improve your defecating & bowel relaxation technique. I'm thinking of getting one myself. Try a medical equipment supplier or search the web for 'biofeedback'.
If the above doesn't help, ask a gastroenterologist about factors - both physical and psychological - which might be affecting the sphincter.
* Physical factors include:
- poor diet
- poor sleep
- lack of exercise
- side-effects of drugs
* Psychological ones might include:
- general anxiety or
- being unduly self-conscious when going to the toilet.
Could any of these apply?
* Another cause of constipation can be 'spastic pelvic floor syndrome', also known as 'anismus'. This involves the muscles around the anus coordinating wrongly and inadvertently closing the anal canal when you're straining to defecate.
* Other, less likely causes of your severe constipation might be the following types of rectal obstruction:
- a 'rectal intussusception'
- a 'rectal prolapse'
- a 'rectocele'
I don't know anything at all about these except that they involve a change in the physical shape of the rectum. A gastroenterologist should be able to help if your problem hasn't corrected itself by this stage.
See also the letter from Gabby posted in Bowel Disorders (old section) in October - she has a very similar problem to yours.
A good stool softener you can by over the counter is colace aka docusate sodium. It is never a good idea to sit on the toilet for long periods of time as another poster recommended since this too can cause hemorrhoids. But do remember that consitpation refers to hard dry infrequent stools. I found you post a bit confusing since you said your stools are soft.
Thank you all for responding. sometimes I feel like Im the only one with this. John, thanks for taking the time to write all that information. Much of it "hit the nail on the head" Im very sluggish and depsondent. If I can furhter explain the symptoms:
I drink alot of water, eat bran, veggies, so the stool is not hard. The problem is with the anus that gets so tight, it won't let anything out. Thus, I think the colon stops trying. A doctor couldnt help - he said just take laxatives. Bad answer. While they help sometimes, other times they make me go a little (in the form of diarreah) but the urge doesn't come back and all that diahrreah stays inside making me more ill.
Should I try that colonic irrigation thing? Im so self conscious of this, but I know i have to do something. Its making me very depressed.
I've read your comments carefully and am quite sure that you've got exactly the same symptoms I had. I'm 99% certain that, as I suspected, you have a blockage - a 'plug', if you like - of old, dry impacted faeces lodged inside your rectum, and that more recent waste matter is forcing its way past it. This will be the main thing that's making you feel lousy. In addition the diarrhoea will make you feel completely worn out, so you're probably sleeping a lot, as I did.
I'll try to respond to your points one-by-one.
Your diet seems to me to be fine for the time being. Even if you have the perfect diet, it's not going to make much difference, and there won't be much improvement, as long as you've got the 'plug' of older faeces lodged inside your rectum. If at present you feel hot and sore around the anus after defecating, or you're passing liquid, I would even try easing off a bit on the water or trying not to take too much after (say) 7 o'clock at night. This might give your stools a chance to harden a little and so push out more of the dry plug when you do eventually go. You need to keep the stool just soft enough so that it will actually force its way past the 'plug', but it also doesn't want to be too liquidy.
You mention the anus tightening. This also happened to me. Obviously any dry stool inside has little hope of getting out if the anal muscles (the anal sphincters) are tight, and any soft stool will only get out either in narrow stools, or else as liquid from higher up in the colon, together with the odd lump that's broken off from the plug - the 'impacted stool'. Anything that doesn't get out, will start to build up around and behind this plug and make matters (even) worse, which you want to avoid.
At the same time it's worth thinking about whether your stress/despondency/worries (on top of the constipation) are perhaps contributing to the problem not of your colon, but of the tightness in your anal muscles. This is why I mentioned in Message 1 how psychological factors can make constipation even worse. However, this may be something you won't start making improvements on unless/until after your guts have improved physically.
You mention feeling very self-conscious about your constipation. I had the same. Is your self-consciousness one of:
i) 'I feel embarrassed about being constipated/other people must laugh at me/they must look down on me/it's notsomething I can talk about easily' or more one of
ii) 'I'm embarrassed at the number of times I have to go to/the smell/the noise I must be making whilst on the toilet'?
Is it i), ii), or both?
In my case there were definite psychological factors which prevented the anus from relaxing quite apart from the physical problems, and so made the problem even worse: I'd become so self-conscious of defecating/making a noise/leaving a smell, that I became extremely tight 'down there' whenever I tried to defecate. For over a year, in desperation I was turning the bath taps on as loudly as possible to disguise any possible noise, taking a radio in with me - anything to disguise the noise. I can see looking back that I was going completely over the top - no-one, apart from me of course, was in the least bit interested. But then I was desperate.
So it's a matter of: a) getting the old stuff out; b) getting the colon into better shape; and c) getting the right stool consistency so that you become more regular, hopefully (eventually) without laxatives; and later on, perhaps working on the psychological problems.
Your first priority, I suggest, is to get rid of the old stuff. Remember that with a plug like this inside your body, you're effectively carrying a load of putrefied rubbish around inside you - toxins - that the body really wanted to be shot of days, possibly weeks ago. Freeloaders.
A colonic hydrotherapist [hydro=water, therefore, 'water therapist'] should help you achieve this as well as b) above. Note that I can't guarantee that it'll work - it may only work in 10% of cases. Or it might be 90%, I don't know. So tell yourself not to expect anything. But I would definitely start looking around for one rather than a gastroenterologist and certainly not a GP. It's not painful and is almost pleasant. Ring two or three (if they're available), describe what you suspect is going wrong - the drying out etc, - and ask what they can do and how much they'll charge, and go for one. Tell them that firstly you want the 'plug' removed but are also interested in colonic irrigation. And if they say that constipation isn't really a problem, or eat more fibre, go straight to someone else. As for c) above, my own hydrotherapist suggested a particular herbal preparation after about the colonic irrigation session. I can get you the details if required.
Here in Britain colonic hydrotherapy has only been going for 5-10 years, but I would try looking in Yellow Pages and searching on the web. Again, ask if you have problems.
Laxatives aren't really the answer - they're only a short-term remedy and tend to pulverise the digestive system and don't get at the root cause. There's a whole industry built up around telling people that if you've got constipation, the answer is to take a laxative. There's also evidence that in the long term they might make some forms of constipation worse. But for the time being, if they're the only way you can get things moving, I would keep with them. Ask your colonic hydrotherapist if/when you should stop using them.
Finally, a bit more on the mental health side: Constipation undoubtedly brings on depression after only a day or so, because you feel so completely different - worn out, despondent, thinking 'Why me?' The toxins (mentioned above) don't help either. The depression, in return, will affect your bowel. The rectum and anus, both of which seem to have died on you in your case, have their own nervous system (the enteric nervous system) which is separate from the body's main (central) nervous system, but is still affected by it. The ENS is very susceptible to psychological pressures. It means that if you're feeling sluggish and depressed, which is understandable, it will tend to make your colon feel sluggish also. It's not about having a 'lazy' colon as your mother suggested, but more that the colon is 'dying' on you. So there's a vicious circle that you'll need to break. For this reason, it might be worth seeking psychiatric help to help you with this - but if you feel that the other person simply doesn't understand how badly severe constipation can affect you, and starts (for example) to tell you not to worry, or that you're being obsessive, I would go to someone else.
I don't know anything about that colonic irrigation procedure, although it sounds reasonable, it doesn't sound like a long term solution. Maybe initially to get you cleaned out would be good, but then I think you should read some of Harry's longer posts on the old board about fiber supplements. A fiber diet just doesn't seem to be enough for a lot of people, besides many of the high fiber foods irritate people's stomachs, where supplements don't. Get more information from old posts and good luck with whatever you try. Ann
[This message has been edited by Ann S (edited 01-23-2001).]
Just to experiment, the next time you are impacted try taking a dose of epsom salts. The instructions will be on the carton. Epsom salts do not act like other laxatives. They cause the bowel to contract. That appears to be your main problem. Just some words of caution. One, don't use epsom salts very often or you can make your problem worse. Two, if you use epson salts, do not get far from the toilet. Because, when it kicks in, you WILL go and quickly.
Epsom salt? I never heard of that remedy, but I will check into it.
I went for a colonic yesterday. Although not as pleaseant as I thought it would be, it wasn't too bad. my "insides" weren't as bad as I thought, no blockage, but I still don't think it did the job. It appears the anus is just not cooperating (relaxing) enough to let things out. Im not sure where to go from here.
Constipation can result from an imbalance in the calcium-magnesium ratio. We need about twice the magnesium than calcium.
I take 500 mg. magnesium every night, and my constipation problem has vanished. Makes sense, as this is where we get "milk of magnesia"! It is a needed mineral and is not just another laxative, even though it does have a laxative ACTION.
Magnesium also makes calcium assimilate into the bone instead of the soft tissues where it may become bone spurs and those *****ly pains in the heels. Those will dissolve with adequate magnesium.
To "awaken" the intestines and bowel, get live acidophilus from a healthfood store. Ask a clerk, as most can tell you which is better. It is usually refrigerated. This restores the noraml flora in there that moves the waste along. I always take this after antibiotics, which kill all helpful bacteria along with the bad.
I find that a B 100 complex vitamin helps also, as it feeds the nerves.
Let us know if anything helps!
[This message has been edited by friend (edited 02-04-2001).]
Well, I go for the third, and final, colonic today. Im not sure if it's helping, but it can't hurt. Im going to try a few different things - magnesium, prunes, flax seed, creams (for lubrication). I know many of you recommend fiber, but that is not always the solution in itself for a severe problem As John knows, it can make it worse.
Thanks to everyone, especially John from the UK for the suggestions. I hope they help. If not, Im doomed to a life of constipation. (and im only 34 )
Hi. I know this topic was posted almost a year ago, but i was wondering how you are doing with this problem so far. Please let me know what methods you are using for constipation. I have the same problem and need some advice. thankyou
Are you quite a private and unemotional person that likes to keep things to themselves? It sounds as if you are and this could be one of the reasons that you are having problems with your bowels. What is it that you are not letting go of emotionally that is making your anus so tight? The mind and the body are linked and it could be an emotional problem that is causing your stomach troubles.
Carry on with the Colinics. They will definitely help and will give your bowels more tone and encourage them to work better. I would also suggest that you go and see a homeopath or an ND that practices homeopathy. After colonics, homeopathic remedies can work more efficiently. Go and give it a try. It is perfectly safe and you might even be surprised with the results.